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Fantasy Is Not a Serious Policy Option

September 10, 2009

by Gene Callahan

You may have seen the status going around Facebook that reads, “[JOHN DOE] thinks that no one should die because they cannot afford health care, and no one should go broke because they get sick.” (This is meant to be an argument for Obama’s health care package, I surmise.)

Well, I posted as my status another blurb, not original to me, that says, “No one should be frozen in carbonite, or be slowly digested for a thousand years in the bowels of a sarlaac, just because they couldn’t pay Jabba the Hut what they owe him.”

Someone, and a serious political theorist to boot, apparently got mad at me, contending (I think — the message was a little vague) that I’m scoffing at political persuasion. But really I’m scoffing at substituting, for any serious discussion of policy, childish fantasizing. Yes, it would be lovely if no one ever died because of a lack of health care funds, in fact, if no one ever got sick, and if baby poop smelled like lavender.

But, no matter what policies we implement, none of these things are going to happen. In particular, people, under any organization of medical care, will die due to a lack of funds, because we do not live in a world of infinite resources. True, if medicine were fully socialized, and treatment was always free to the consumer, no one would die due to a lack of funds on their own part — instead, people would die due to lack of government funds.

The state running the socialized medical system has to stop spending at some point — for instance, it can’t come anywhere near spending 100% of GDP on medical care, because then people would die of starvation! — and it will always be the case that if the government had spent more than it did, some people would have lived longer.

A serious discussion of these issues should begin by being adults here, and recognizing that we live in a world in which we must make trade-offs. Some people will die who might have been kept alive a bit longer by devoting more resources to their care, no matter what we do. Having recognized that, now we can begin to discuss what policy will result in minimizing those deaths, or distributing them better, or whatever other goals we bring to the table.

And, lest anyone think I’m being partisan here, this silliness is an equal opportunity affliction. A “war to end terror” is not an adult project; an adult recognizes that terrorism will occur, and asks how to minimize it.

A “drug-free America” is not an adult goal; an adult realizes that some people will find a way to get high under any regime, and asks how to best minimize the harm involved. (And the answer arrived at, e.g., for the last issue may be anything from “full legalization” to “the current system”; my point here is not to criticize particular policies, but the land-of-make-believe approach to formulating and arguing for any policy whatsoever.)

UPDATE: It turns out the political theorist who commented was speaking, not for himself, but in imitation of some of his healthcare-reform-supporting friends who would say what he said — but the rest of the post stands as is, I think.

Nice, Gene. I sometimes compare the war on drugs to an imaginary war on sex. If the government were to crack down on sex, would people still have sex? What if we created a sex police to prevent people from having sex? Would the sex police have sex? The war on sex would be futile and destructive, so is the war on drugs.

[…] have a right to health care — that is, a right to other people’s labor — or that resources are not scarce. Yet that is what Obama & Co. are doing. A core principle of their scheme is that no one could […]

You’re correct about that Facebooker’s absurdity in desiring no deaths through a lack of health care funds; that comment is surely meant for a bumper sticker rather than a serious policy point.

But it’s the other side of the argument that is the usual culprit of bizarre absolutism. Of course something has to allocate finite resources, but the assumption that the most efficient (putting aside desirable, even) method is through the market leaves me scratching my head.

The “free” market, sure… but what definition of free market are we going with here? I can’t choose my health care provider. I can’t round up a few million dollars from investors and start up a competitive healthcare company.

I think the common mistake of the far left is, indeed, to be a little too hippy-dippy about making sure no one ever gets hurt. The far left.

I think the common mistake of the center right (and beyond), is believing corporatism is capitalism.

Did anyone notice that in his address to Congress, the President listed “[no] cap on the amount of coverage you can receive in a given year or in a lifetime” as one of his non-negotiable requirements imposed on private insurers? Along with an end to differentiation between low and high risk applicants?

It’s the same fantasy as the Facebook nonsense, dressed up to sound reasonable. Only in this case, the perpetrator understands it is deception.

“True, if medicine were fully socialized, and treatment was always free to the consumer, no one would die due to a lack of funds on their own part — instead, people would die due to lack of government funds.
”

Exactly.

Socialist health-care is not a proxy for not a lack of funds – it just means rationing and indirect payment. Oh, and inefficiency, red tape and lots of politics.

[…] they have a right to health care–that is, a right to other people’s labor–or that resources are not scarce. Yet that is what Obama & Co. are doing. A core principle of their scheme is that no one could […]

The argument above is thoroughly ridiculous — because it brings a point to an extreme. And extremes are ridiculous.

Consider law enforcement: no theft should go unpunished, because it is an infringement of the freedom of the victim. So the law says, already, today.

Does this mean that the budget for law enforcement should be unlimited? Does that mean that everyone should carry a tracker chip to ensure their location can be recorded at any time?

No, it means that people have a (somewhat limited in practice) right to access to the courts and to the police to be paid with taxes, and every time they report a crime or go to court they STEAL FROM OTHER PEOPLE’S PROPERTY.

And if you want TO STEAL MY PROPERTY to pay for a legal system that protects you from crime, why should I consent? I might want a different legal system from the one you or even a majority wants, or even no legal system

But if you make me pay taxes for a legal system, it is just you with the big gun of the government pointed at my head saying “PAY UP OR ELSE” to fund you pet legal system government project. Even if I don’t think that paying taxes for a legal system is a bargain of mutual advantage, and it benefits you more than me.

How is this different from the pet project being healthcare where the group purchasing scheme is for access to doctors and hospitals, instead of the police and courts?

How is STEALING OTHER PEOPLE’S PROPERTY to pay for a legal system different from doing the same for a healthcare system?

“Should” implies “can”. The original statement rests on the ridiculously extreme assumption that it is even possible in the real world to have a situation where no-one dies because of lack of medical resources and all sickness can be healed without regard to cost. Clearly this is impossible in the real world where resources are scarce.

So to say that no-one should die because of scarcity (when we know that can never actually happen) is at best a statement of preference (I would like it if no-one ever died because of the scarcity of medical resources”). It is not in anyway a meaningful contribution to the policy debate as to how to reduce the number of people who die because medical resources are in fact scarce.

You’ve made the same error in your arguement when you write that “no theft should go unpunished”. Unless you demonstrate some way we can ensure that in fact no theft ever goes unpunished, your should is just a statement of your preference (“I would like it if no theft went unpunished”).

«You’ve made the same error in your arguement when you write that “no theft should go unpunished”. Unless you demonstrate some way we can ensure that in fact no theft ever goes unpunished, your should is just a statement of your preference (”I would like it if no theft went unpunished”).»

Not me — the law makes that mistake. The law says that every single theft is forbidden, and is punished as a felony, and in way of principle anybody that reports a theft is entitled to the protection of the police and the courts.

The *principle* is that nobody should be denied the protection of the police, nobody should be denied access to the courts, even if resources are limited. Then when resources are limited, stuff happens, but that is note a matter of legislative policy but of implementation.

Do you think otherwise, and that in a world of finite resources some thefts are more important than others, the the others should be ignored by the police and the courts, as a *matter of principle*?

For example, the argument might be that stealing from a wealthy person is a grave crime because it punishes a producer and creator who has contributed a lot of value to those who have traded with him, while stealing from a poor person in a world of finite legal resources should not be a crime, as it punishes someone who has produced and created very little.

One way to achieve that would be to have legal-protection savings accounts, and the police or the courts would only consider a crime where the victim had enough money in their account to pay for the protection fee appropriate for that crime. In this way the government would not have to STEAL THE PROPERTY of those who don’t want pay to be protected by the police or the courts.

But otherwise, if even those who cannot afford the protection fee are allowed to utilize the services of the police and the courts, the argument is that all acts of (e.g.) theft should be considered crimes, as a matter of principle, regardless of scarce resources.

And if you support the idea that the government should consider as crimes all thefts, and (to secure the necessary and potentially unlimited resources) CONFISCATE SOME PROPERTY from those unwilling to contribute to the police and courts setup by the majority, and that majorities can CONFISCATE THE PROPERTY of minorities to pursue their pet projects.

Or else you can argue that some majority pet projects are important enough to coerce minorities into contributing to their funding, and others, equally supported by majorities, are not. And what gives you the right to decide when the majority is right and when it is wrong?

«Blissex, you’ve completely missed Gene’s point. The ridiculous extreme is in the original statement.»

OK, I’ll be less funny here: the ridiculous extreme that I was mocking is that since some aim is in fact impossible to achieve 100%, it should not be a policy aim.

That this is a ridiculous extreme type of argument seems to me obvious also here:

“The state running the socialized medical system has to stop spending at some point — for instance, it can’t come anywhere near spending 100% of GDP on medical care, because then people would die of starvation!”

That argument-by-strawman is ridiculous, because the quote being ridiculed says “no one should die because they cannot afford health care,”, not “no one should die because THE STATE cannot afford medical care”.

It is strictly about individuals and affordability. It is an argument about the resources of the individual vs. the resources of the state. it is an argument for a wide insurance pool making available finite resources but beyond what any one individual can afford, not for unlimited resources.

And as such it applies to any insurance and group purchase scheme.

And “should” (which is not “shall”) is a standard legislative principle (and much legislation does say “shall”); an aim, not a guarantee.

Nobody *should* be coerced by the government into a bargain they don’t consider of their advantage — YES or NO?